Non-invasive and minimally invasive staging of regional lymph nodes in penile cancer

Abstract Background The aim of this study is to evaluate the microstructure and microcirculation of regional lymph nodes (LNs) in rectal cancer by using non-invasive intravoxel incoherent motion MRI (IVIM-MRI), and to distinguish metastatic from non-metastatic LNs by quantitative parameters. Methods All recruited patients underwent IVIM-MRI (b = 0, 5, 10, 20, 30, 40, 60, 80, 100, 150, 200, 400, 600, 1000, 1500 and 2000 s/mm2) on a 3.0 T MRI system. One hundred sixty-eight regional LNs with a short-axis diameter equal to or greater than 5 mm from 116 patients were evaluated by two radiologists independently, including 78 malignant LNs and 90 benign LNs. The following parameters were assessed: the short-axis diameter (S), long-axis diameter (L), short- to long-axis diameter ratio (S/L), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion factor (f). Intraclass correlation coefficients (ICCs) were calculated to assess the interobserver agreement between two readers. Receiver operating characteristic curves were applied for analyzing statistically significant parameters. Results Interobserver agreement of IVIM-MRI parameters between two readers was excellent (ICCs> 0.75). The metastatic group exhibited higher S, L and D (P < 0.001), but lower f (P < 0.001) than the non-metastatic group. The area under the curve (95% CI, sensitivity, specificity) of the multi-parameter combined equation for D, f and S was 0.811 (0.744~0.868, 62.82%, 87.78%). The diagnostic performance of the multi-parameter model was better than that of an individual parameter (P < 0.05). Conclusion IVIM-MRI parameters provided information about the microstructure and microcirculation of regional LNs in rectal cancer, also improved diagnostic performance in identifying metastatic LNs.

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Sarcoidal reactions in regional lymph nodes of patients with non-small cell lung cancer: Incidence and implications for minimally invasive staging with endobronchial ultrasound

Lung Cancer ◽

10.1016/j.lungcan.2009.03.001 ◽

2009 ◽

Vol 66 (3) ◽

pp. 305-308 ◽

Cited By ~ 31

Author(s):

Daniel P. Steinfort ◽

Louis B. Irving

Keyword(s):

Lung Cancer ◽

Minimally Invasive ◽

Lymph Nodes ◽

Small Cell Lung Cancer ◽

Cancer Incidence ◽

Small Cell ◽

Endobronchial Ultrasound ◽

Lung Cancer Incidence ◽

Small Cell Lung ◽

Regional Lymph Nodes

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PENILE CANCER

The Professional Medical Journal ◽

10.29309/tpmj/2009.16.04.2753 ◽

2009 ◽

Vol 16 (04) ◽

pp. 606-608

Author(s):

MUTAHIR ALI TUNIO ◽

MANSOOR RAFI ◽

ALTAF HUSSAIN HASHMI

Keyword(s):

Lymph Nodes ◽

Distant Metastasis ◽

Penile Cancer ◽

Skin Metastasis ◽

Regional Lymph Nodes ◽

Metastatic Pattern

Carcinoma of the penis has a well documented metastatic pattern, regional lymph nodes being the predominant site ofinvolvement. Distant metastasis is extremely rare, with a reported incidence of 1-10%. Skin metastasis is even rarer and three cases ofmetastasis to the skin have been reported previously worldwide. We present a case of carcinoma of the penis metastasizing to the skin of trunk.

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Penile Cancer Pathologic Regional Lymph Nodes TNM Finding v7

10.32388/mxw3qd ◽

2020 ◽

Author(s):

Keyword(s):

Lymph Nodes ◽

Penile Cancer ◽

Regional Lymph Nodes

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R-veil in carcinoma vulva

10.1055/s-0039-1685390 ◽

2016 ◽

Author(s):

Vandana Jain ◽

Rupinder Sekhon ◽

Shveta Giri ◽

Sudhir Rawal

Keyword(s):

Minimally Invasive ◽

Lymph Nodes ◽

Vulvar Cancer ◽

Invasive Procedure ◽

Oncologic Outcomes ◽

Invasive Technique ◽

Surgical Morbidity ◽

Regional Lymph Nodes ◽

Open Procedure ◽

Node Metastases

Background: Vulvar cancer accounts for about 3-5% of gynaecologic malignancies. Prognosis is strongly dependent on presence of inguinofemoral lymph node metastases. Effective management of regional lymph nodes is the most important factor in the curative management of early vulvar cancer. Despite careful dissection and maintaining vascularity of skin, surgical morbidity is seen in 50% cases. Video – endoscopic inguinofemoral lymphadenectomy was developed by Bishoff in 2003 by dissecting two cadaveric models and in one patient with stage T3N1M0 penile carcinoma. VEIL is an alternative to reduce the morbidity without compromising the oncologic outcomes. VEIL has continued to evolve into single site and robotic variants. R-VEIL is a minimally invasive procedure duplicating the standard open procedure with less morbidity. Aims and Objectives: A video presentation to describe the technique of R-VEIL in vulvar cancer and discuss the advantages and outcome. Conclusions: R–VEIL is an attractive minimally invasive technique to do inguinal block dissection in a single sitting in patients with vulvar carcinoma as the surgeon does not get tired as happens in VEIL technique. R-VEIL allows the removal of inguinal lymph nodes within the same limits as in open procedure and potentially reduces surgical morbidity. It is better accepted cosmetically and reduces hospital stay. Long term oncological results are not available. Randomized multi-institutional studies are required to prove its efficacy over open counterpart.

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Utility of Minimally Invasive Technology for Inguinal Lymph Node Dissection in Penile Cancer

Journal of Clinical Medicine ◽

10.3390/jcm9082501 ◽

2020 ◽

Vol 9 (8) ◽

pp. 2501

Author(s):

Reza Nabavizadeh ◽

Benjamin Petrinec ◽

Andrea Necchi ◽

Igor Tsaur ◽

Maarten Albersen ◽

...

Keyword(s):

Lymph Node ◽

Minimally Invasive ◽

Lymph Nodes ◽

Lymph Node Dissection ◽

Penile Cancer ◽

Inguinal Lymph Node ◽

Node Dissection ◽

Inguinal Lymph Node Dissection ◽

Inguinal Lymphadenectomy ◽

Operative Complications

Our aim is to review the benefits as well as techniques, surgical outcomes, and complications of minimally invasive inguinal lymph node dissection (ILND) for penile cancer. The PubMed, Wiley Online Library, and Science Direct databases were reviewed in March 2020 for relevant studies limited to those published in English and within 2000–2020. Thirty-one articles describing minimally invasive ILND were identified for review. ILND has an important role in both staging and treatment of penile cancer. Minimally invasive technologies have been utilized to perform ILND in penile cancer patients with non-palpable inguinal lymph nodes and intermediate to high-risk primary tumors or patients with unilateral palpable non-fixed inguinal lymph nodes measuring less than 4 cm, including videoscopic endoscopic inguinal lymphadenectomy (VEIL) and robotic videoscopic endoscopic inguinal lymphadenectomy (RVEIL). Current data suggest that VEIL and RVEIL are feasible and safe with minimal intra-operative complications. Perhaps the strongest appeal for the use of minimally-invasive approaches is their faster post-operative recovery and less post-operative complications. As a result, patients can tolerate this procedure better and surgeons can offer surgery to patients who otherwise would not be a candidate or personally willing to undergo surgery. When compared to open technique, VEIL and RVEIL have similar dissected nodal count, a surrogate metric for oncological adequacy, and a none-inferior inguinal recurrence rate. Larger randomized studies are encouraged to investigate long-term outcome and survival rates using these minimally-invasive techniques for ILND.

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ANTIMICROBIAL THERAPY DURING CANCER TREATMENT: A CASE REPORT

Siberian Journal of Oncology ◽

10.21294/1814-4861-2021-20-4-160-165 ◽

2021 ◽

Vol 20 (4) ◽

pp. 160-165

Author(s):

Z. V. Grigoryevskaya ◽

V. B. Matveev ◽

D. A. Sergeev ◽

I. V. Tereshchenko ◽

V. D. Vinnikova ◽

...

Keyword(s):

Lymph Nodes ◽

Penile Cancer ◽

Clinical Effect ◽

Infection Process ◽

Regional Lymph Nodes ◽

Left Groin ◽

Inguinal Lymphadenectomy ◽

Ulcerative Lesions ◽

Inflammatory Changes ◽

Infected Tumor

Introduction. Penile cancer (pc) is a rare cancer. The standardized incidence rate of pc in russia is 0.82 cases per 100,000 males. On average, 58 % of patients (20–96 %) with pc have a local infection process: tumor decay, the presence of erosion, tumor ulceration, inflammatory changes in regional lymph nodes, etc. During hospitalization nosocomial pathogens may be possible causes of infection in ulcerative lesions.The aim of the study was to present the results of the treatment of tumor ulcer in a patient with penile cancer infected with multiresistant acinetobacter baumannii and klebsiella pneumoniae.Material and methods. We present a clinical observation of 54-year-old patient diagnosed with penile cancer pt4n3m0, with ulceration of the tumor, localized at the root of the penis and ulceration of metastatic lymph nodes in the left inguinal region and subsequent infection with highly resistant nosocomial microorganisms.Results. The patient received 6 courses of paclitaxel, ifosfamide and cisplatin with clinical effect, such as significant reduction of the tumor and therapeutic pathomorphosis of 3-rd degree. Then ileo-inguinal lymphadenectomy was performed on the left. A few months later the tumor continued to grow in the left groin area. During the 2nd line of chemotherapy (cisplatin, docetaxel and capecitabine), the patient had grade iii–iv neutropenia, febrile neutropenia. High fever and localized infection in the area of tumor ulceration with multiresistant hospital microorganisms was detected. Combined antibiotic therapy had temporary effect. After isolation of multiresistant carbapenemresistant k. Pneumoniae from the ulcer, the patient was prescribed ceftazidim/avibactam 2.5 g 3 times a day. Clinical effect, such as defervescence and significant reduction of the ulceration zone was seen subsequently.Conclusion. Etiotropic antibacterial therapy of the infected tumor ulcer resulted in a significant reduction in the manifestation of the infection process, allowing antitumor therapy to be continued, as well as surgery to be performed.

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